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lochstockandbarrel@yahoo.com
817-923-4638
Order form
Customer name:_________________________________________________________________________
Address:_______________________________________________________________________________
City, state, zip:____________________________________________________________________________
Phone:_________________________________________________________________________________
e-mail:_________________________________________________________________________________
Item ordered:____________________________________________________________________________
Color/Tartan:_____________________________________________________________________________
Measurements: (A)_______(B)_______(C)_______(Chest - for shirt)_________________________________
Options:_________________________________________________________________________________
Cost:____________________________________________________________________________________
Payment Method: Cash _____ USPS M.O. _____ Cashier's Check _____ Personal Check ____ Credit Card ____
Credit Card Type: VISA______________________ MasterCard_____________________
Card Number:___________________________________________Expiration Date_______________________
Credit Card Security Code (the 3 numbers on the right or the signature block on the back) ___________________
NOTE: We cannot process your card without this number
SPECIAL INSTRUCTIONS:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
We are in the process of updating this website, and are unable to complete this form online. Please copy or print
it, complete it, the scan and e-mail it, send it by regular mail (Loch, Stock and Barrel, 2019 Lipscomb, Fort Worth,
Texas 76110), or call us. Thanks for your patience!